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Purpose The study report describes a rare bilateral variant of a six- and five-headed coracobrachialis muscle (CB). The musculocutaneous nerve (MCN) (bilaterally) and the median nerve (MN) lateral root (unilaterally) pierced CB heads, separating superficial from deep heads. Methods The variant bilateral CB was identified in a 78-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent. Results At the right side: The 6-headed CB was pierced by the MCN, while the MN lateral root pierced the one superficial and deep head. CB was supplied by the lateral cord and the MCN. At the left side: A 5-headed CB was identified with three superficial distinct origins that fused into a common superficial head coursing anterior to MCN. The variant CB bilaterally (with 11 heads in total) coexisted with a MN variant formation, an atypical course of the MN lateral root through CB (right side), a connection of the MN lateral root with the MCN (left side) and a variant axillary artery branching pattern (bilaterally). Conclusions Course and direction of the accessory CB heads may occasionally entrap the MCN and/or adjacent structures (brachial artery and MN). The MCN compression results in problems in the glenohumeral joint flexion and adduction, and tingling or numbness of the elbow joint, the forearm lateral parts and the hand.

Reviews and meta-analyses concerning the effectiveness of extended reality technologies (ERTs) (namely virtual, augmented, and mixed reality-VR, AR, and MR) in anatomy education (AE) have resulted in conflicting outcomes. The current review explores the existing evidence provided by reviews of AE literature regarding the effectiveness of ERTs after their comparison with traditional (either cadaveric or two-dimensional) anatomy teaching modalities and sheds light on the factors associated with the conflicting outcomes.PubMed, SCOPUS, ERIC, and Cochrane databases were searched for review articles with the purpose to investigate the effectiveness of ERTs in AE.Nine (four systematic with or without meta-analysis and five non-systematic) reviews were included. A lack of robust evidence provided by those reviews was noted, mainly due to a remarkable confusion in the definition of each ERT, along with confusion when authors referred to traditional AE (TAE) methods.To clarify to what extent VR, AR, or MR can replace or supplement TAE methods, there is a primary need for addressing issues regarding the definition of each technology and determining which specific TAE methods are used as comparators.

Purpose The report describes a bilateral suprascapular artery (SPSA) of atypical origin in coexistence with neurovascular aberrant structures. Methods The variants were identified in a 91-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent. Results The left-sided SPSA emanated from the 1st part of the axillary artery, coursed between the brachial plexus lateral and medial cords, accompanied by the suprascapular nerve, and passed below the superior transverse scapular ligament. Ipsilateral coexisted variants were the lateral thoracic artery multiplication, the subscapular trunk formation, and the musculocutaneous nerve duplication. In the right supraclavicular area, a SPSA duplication was identified. The main artery emanated from the thyrocervical trunk in common with the transverse cervical artery and the accessory SPSA emanated from the dorsal scapular artery. Both SPSAs coursed over the superior transverse scapular ligament, while the suprascapular nerve ran below the ligament. Conclusions The current study reported a bilateral aberrant SPSA, originating from the AA 1st part (left side) and from the dorsal scapular artery (right side), which coexisted with adjacent neurovascular structures’ variants. The left SPSA atypically coursed below the superior transverse scapular ligament. Such an unusual combination of variations, present bilaterally in the current study, may be challenging for radiologists and surgeons.

Purpose The current cadaveric case series evaluates and reports the morphology of the coracobrachialis muscle (CB), and the related musculocutaneous nerve (MCN) origin, course, and branching pattern, as well as associated adjacent muscular and neural variants. Materials and Methods Twenty-seven formalin embalmed cadaveric arms (24 paired from 12 cadavers and 3 unpaired), were dissected to identify the CB possible variants with emphasis on the MCN course and coexisted neural variants. Results Four morphological types of the CB were found: a two-headed in 62.96% (17/27 arms), a three-headed in 22.2% (6/27), a one-headed in 11.1% (3/27) and a four-headed in 3.7% (1 arm). A CB variant morphology was identified in 37.04% (10/27). A three-headed biceps brachii coexisted in 23.53% (4/17). Two different MCN courses were recorded: a course between CB superficial and deep heads (in cases of two or more CB heads) (100%, 24/24), and a medial course in case of one-headed CB (100%, 3/3). The interconnection of the lateral cord with the median nerve median root was identified in 18.52%, the MCN with the median nerve in 7.41% and of the radial with the ulnar nerve in 3.71%. Duplication of the median nerve lateral root was identified in 11.1%. Conclusions The knowledge of the morphology of the muscles of the anterior arm compartment, especially CB variant morphology and the related MCN variable course, is of paramount importance for surgeons. Careful dissection and knowledge of relatively common variants play a significant role in reducing iatrogenic injury.

Purpose The current report describes a rare bilateral suprascapular artery (SPSA) of ectopic origin. Coexisted neurovascular aberrant structures were also identified and considered from a clinical point of view. Methods The variants were identified in a 91-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent. Results In the left axilla, the SPSA emanated from the 1st part of the axillary artery, coursed between the brachial plexus lateral and medial cords, accompanied by the suprascapular nerve, and passed below the superior transverse scapular ligament. Ipsilateral coexisted variants were the lateral thoracic artery multiplication, the subscapular artery division into multiple branches, and the musculocutaneous nerve and the median nerve lateral root duplication. In the right supraclavicular area, a SPSA duplication was identified. The main artery emanated from the thyrocervical trunk in common with the transverse cervical artery and the accessory one from the dorsal scapular artery. Both SPSAs coursed over the superior transverse scapular ligament, while the suprascapular nerve ran below the superior transverse scapular ligament. Conclusions The SPSA atypical origin, course and location is clinically important, as the artery is usually identified and ligated during surgery. The SPSA atypical course below the superior transverse scapular ligament may be a risk factor for the suprascapular nerve compression.

Purpose The study-report describes a rare bilateral variant of a six- and five-headed coracobrachialis muscle (CB). The musculocutaneous nerve (MCN) (bilaterally) and the median nerve (MN) lateral root (unilaterally) pierced CB heads, separating superficial from deep heads. Methods The variant bilateral CB was identified in a 78-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent. Results At the right side: The 6-headed CB was pierced by the MCN, while the MN lateral root pierced the one superficial and deep head. CB was supplied by the lateral cord and the MCN. At the left side: A 5-headed CBM was identified with three superficial distinct origins that fused into a common superficial head coursing anterior to MCN. The variant CB bilaterally (with 11 heads in total) coexisted with a MN variant formation, an atypical course of the MN lateral root through CB (right side), a connection of the MN lateral root with the MCN (left side) and a variant axillary artery branching pattern (bilaterally). Conclusions Course and direction of the accessory CB heads may occasionally entrap the MCN and/or adjacent structures (brachial artery and MN). The MCN compression results in problems in the glenohumeral joint flexion and adduction, and tingling or numbness of the elbow joint, the forearm lateral parts and the hand.

BACKGROUND: Pterion is the junction of the frontal, parietal, greater wing of the sphenoid and the squamous part of the temporal bone. The sphenoparietal, frontotemporal, stellate and epipteric pteria were described. The current study determines pterion topography, morphology (variant types' frequency) and morphometry, as well as epipteric bones presence in dried skulls. Gender impact is underlined as well. MATERIALS AND METHODS: Ninety Greek adult dried skulls were observed. The distances in between pterion and the zygomatic arch midpoint and in between pterion and the frontozygomatic suture were measured. RESULTS: The sphenoparietal pterion was the commonest (58.3%), following by the stellate (25%), epipteric (15.5%) and by the frontotemporal pterion (1.1%). Twenty-eight (15.5%) skulls had epipteric bones, further categorised as quadrisutural (35.7%), trisutural (57.1%), bisutural and multiple (3.57%). The mean distances between pterion and the midpoint of zygomatic arch were 4.13 ± 0.45 cm on the right and 4.09 ± 0.47 cm on the left side and between pterion and the frontozygomatic suture were 3.47 ± 0.61 cm on the right and 3.52 ± 0.65 cm on the left side. Both distances were symmetrical. Male skulls showed slightly higher values on the left side for the distance (pterion-midpoint of zygomatic arch). CONCLUSIONS: Pterion is a commonly used neurosurgical landmark and thus in depth knowledge of the pteric area and its variants could be valuable. Recognition of the possible variability in pterion location, morphology and morphometry, as well as possible occurrence of epipteric bones may render pterional craniotomy safer among different population groups. ispartof: FOLIA MORPHOLOGICA vol:80 issue:4 pages:994-1004 ispartof: location:Poland status: published

In the modern era, preoperative planning is substantially facilitated by artificial reality technologies, which permit a better understanding of patient anatomy, thus increasing the safety and accuracy of surgical interventions. In the field of orthopedic surgery, the increase in safety and accuracy improves treatment quality and orthopedic patient outcomes. Artificial reality technologies, which include virtual reality (VR), augmented reality (AR), and mixed reality (MR), use digital images obtained from computed tomography or magnetic resonance imaging. VR replaces the user's physical environment with one that is computer generated. AR and MR have been defined as technologies that permit the fusing of the physical with the virtual environment, enabling the user to interact with both physical and virtual objects. MR has been defined as a technology that, in contrast to AR, enables users to visualize the depth and perspective of the virtual models. We aimed to shed light on the role that MR can play in the visualization of orthopedic surgical anatomy. The literature suggests that MR could be a valuable tool in orthopedic surgeon's hands for visualization of the anatomy. However, we remark that confusion exists in the literature concerning the characteristics of MR. Thus, a more clear description of MR is needed in orthopedic research, so that the potential of this technology can be more deeply understood.

Purpose The suspension imposed on Universities due to COVID-19 pandemic impeded students’ educational opportunities. Alternative teaching modalities have been used. Substitution of dissection courses on cadavers was a great challenge. Present study investigates students’ view on the efficacy of the “online” pre-recorded “dissection educational videos” (DEVs) in assisting anatomy teaching, aiming to modernize the lectures and reinforce comprehension. Methods The adequacy of the “online” anatomy courses and a possible new teaching modality were evaluated by the 2nd year pre-graduate students, employing an online questionnaire. Results One hundred and ninety-six volunteer students participated. Before the pandemic, 78.1% of the students constantly attended the “auditorium-based” lectures and 73% used self-teaching tools (STTs) for a better understanding of anatomy. During pandemic, a slight lower frequency (76%) attended the “online” lectures and a higher frequency (84.2%) used at least one STT. Up to 59.2% of the students disagreed with the permanent replacement of the “auditorium-based” by the “online” lectures, while 62.8% supported the idea of parallel conduction of the lectures. Combined teaching tools were the most preferred resources. 83.2% of the students stated that the dissection labs’ cancellation negatively affected their education, and 75.5% supported the permanent addition of the pre-recorded DEV series in the lectures. Conclusions COVID-19 pandemic created the temporary need for pure remote education. During lockdown, the use of STTs has significantly increased. A novel teaching modality (DEV series), presented in the study, can be used both as educational material and as a STT.

Anatomical variations of the portal vein are relatively common and can affect the outcomes of hepatic resections, transplantations and interventional radiological procedures. The aim of this study was to review the literature regarding extrahepatic portal vein anomalies. Two main databases were searched for suitable articles, and results concerning more than 3,700 patients were included in the analysis. The most common anatomical variations of the portal vein were trifurcation and having a right posterior portal vein as the first branch of the main portal vein; these anomalies were found in 11.7% and 10.8% of cases, respectively.

Purpose To answer the question whether bilateral reverse total shoulder arthroplasty (RTSA) is a safe and effective treatment which results in satisfactory clinical and functional outcomes with low complications rates. A second question to be answered was: what is the quality of the evidence of the already published studies which investigate the use of bilateral RTSA? Methods Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “reverse” AND “total” AND “shoulder” AND “arthroplasty” AND “clinical.” Descriptive statistics were used to summarize the data. Results From the 394 initial studies we finally selected and assessed 6 clinical studies which were eligible to our inclusion–exclusion criteria. The aforementioned studies included in total 203 patients (69% females; mean age range: 67.1–75 years; mean follow-up range: 12–61 months). From those, 168 patients underwent staged bilateral RTSA (mean duration between first and second operation range: 8–21.6 months) and the rest of them a unilateral RTSA as controlled treatment. Almost all mean clinical and functional scores, which were used to assess the therapeutic value of bilateral RTSA, depicted significant postoperative improvement in comparison with the mean preoperative values. The modified Coleman methodology score, which was used to assess the quality of the studies, ranged from a minimum of 36/100 to a maximum of 55/100. Conclusion Despite the lack of high-quality evidence, staged bilateral RTSA seems to be a safe and effective procedure for patients with cuff tear arthropathy, which results in significantly improved clinical and functional outcomes and low reoperations' rates. Level of Evidence Systematic review of level III-IV therapeutic studies.

The splenic artery (SA) is the largest and most tortuous branch of the celiac trunk with a wide spectrum of variants, particularly in its terminal branches. The current study presents a systematic review of the English literature on the SA variations, with emphasis on its terminal branching patterns. Thirty cadaveric studies (3132 specimens) were included in the analysis. The SA originated from the celiac trunk in 97.2%, from the abdominal aorta in 2.1% and from the superior mesenteric or the common hepatic artery in 0.7% of cases. A suprapancreatic course was observed in 77.4%, retropancreatic course in 17.8%, anteropancreatic course in 3.4% and intrapancreatic course in 1.3%. In the majority of cases, the SA bifurcated into superior and inferior lobar arteries (83.4%), with trifurcation and quadrifurcation in 11.3% and 2.7%, respectively. Five or more lobar branches (1.4%) and a single lobar artery (1.2%) were rarely identified. The distributed branching pattern was found in 72.7%, whereas the magistral pattern in 26.9%. The inferior and superior polar arteries (IPA and SPA) were found in 47.7% and 41.7% of cases, respectively, while polar artery agenesis was recorded in 28.2%. The SPA usually originated from the SA main trunk (53.6%) or from the superior lobar artery (33.1%). The IPA emanated mainly from the left gastroepiploic artery (53%), from the SA (23.5%) or the inferior lobar artery (21.9%). Intersegmental anastomoses between adjacent arterial segments were identified in 14.2%. Knowledge of the SA aberrations is important for surgeons and radiologists involved in angiographic interventions.

Purpose: Clinically-oriented anatomy education has been proposed as an effective strategy in anatomy curricula. We aimed to explore the level of extent the literature supports the fact that case-based learning (CBL) can play a significant role in anatomy education. Materials and methods: We searched PubMed, Scopus, Education Resources Information Center (ERIC), and Cochrane database to find articles with the purpose to explore the educational outcomes of case-based anatomy learning. We extracted from each paper authors, type of study (comparative or not), number of participants, level of outcome according to the Kirkpatrick hierarchy, outcomes of CBL concerning the acquisition of anatomical knowledge, and the participants’ perceived enjoyment, motivation, and aid to anatomy learning. Results: Nine articles were included. Three of them evaluated the acquisition of anatomical knowledge, while six papers evaluated the participants’ perceptions. All studies showed positive outcomes regarding the students’ anatomy examination performances, reported confidence, enjoyment, motivation, and ability of CBL to facilitate anatomy learning. Conclusion: Although the existing research has mainly evaluated students’ perceptions, the outcomes of CBL in anatomy education encourage more extensive use of this method in anatomy curricula. Further research is expected to shed more light on the role that CBL can play in modern anatomy education and to clarify if it can replace or supplement didactic teaching.

The purpose of this study was to compare the measurement of several anatomical features of the medial patellofemoral ligament (MPFL) between magnetic resonance imaging (MRI) and by direct fashion during dissection. We hypothesized that the measurements between these two techniques would agree. MRI of 30 fresh-frozen cadaveric knees was followed by dissection. MPFL patella and femoral attachment were evaluated, their shape, length, and width were measured, and measurements were compared. MRI was deemed unreliable for the determination of several of the aforementioned anatomical features. Important findings include: (a) observations on MPFL attachment at medial patella side and attachment to quadriceps were identical between dissection and MRI, (b) average width at patella insertion was significantly different between the two methods (p = 0.002), and (c) an attachment to the quadriceps tendon was present in 20/30 specimens and d. detailed measurements of a thin, non-linear, and three-dimensional structure, such as the MPFL, cannot be performed on MRI, due to technical difficulties. This anatomical radiological study highlights the shape, anatomical measurements (length and width), and attachment of the MPFL using a relatively large cadaveric sample and suggests that MRI is not reliable for detailed imaging of its three-dimensional anatomy.

Proprioception is a specialized sensory modality encompassing the movement of the joint and its position in space, and it involves the conversion of mechanical deformation of tissues into neural signals. Mechanoreceptors are specialized nerve structures able to transmit mechanical deformation through electrical signals to dorsal root ganglion sensory neurons and are abundant in the muscles, tendons and ligaments of the knee joint. They are believed to play an important role in knee proprioception and dynamic knee stability. Proprioception should always be taken into consideration for successful reconstruction of the cruciate-deficient knee and for pain and function management in the arthritic knee. Advances in histological methods of detection are numerous and continue to highlight the presence and role of mechanoreceptors after ligament reconstruction, depending on choice of graft. In this review, we present the current knowledge of anterior and posterior cruciate ligaments and grafts mechanoreceptors, and their role in proprioception of knee joint, focusing on each type of mechanoreceptors.

Σύμφωνα με τα βιβλιογραφικά δεδομένα, ήταν απαραίτητη και προτάθηκε μια ταξινόμηση για την αξιολόγηση της πώρωσης των καταγμάτων του Α2 σπονδύλου σε ανατομική θέση, με βάση μετρήσεις σε σπονδύλους ενός ευρωπαϊκού πληθυσμού, ενώ, παράλληλα, συνεστήθη η διεξαγωγή μετρήσεων και σε άλλους πληθυσμούς. Στην παρούσα μελέτη, πραγματοποιήθηκαν μετρήσεις με τη χρήση αξονικής τομογραφίας (CT) στην οδοντοειδή απόφυση του Α2 σπονδύλου 115 Ελλήνων ασθενών, καθώς επίσης και στα εγκάρσια τρήματα και στους αυχένες του Α2 σπονδύλου 55 Ελλήνων ασθενών. Επιπροσθέτως, πραγματοποιήθηκε ανασκόπηση της βιβλιογραφίας σε ό,τι αφορά μετρήσεις στον Α2 σπόνδυλο σε διαφορετικούς πληθυσμούς, έτσι ώστε να καταδειχθεί η κλινική σημασία των ανατομικών παραμέτρων στη χειρουργική της αυχενικής μοίρας της σπονδυλικής στήλης. Από την ανασκόπηση της βιβλιογραφίας προέκυψαν 26 μελέτες που συσχέτισαν την ανατομία του πετάλου του Α2 με τη δυνατότητα τοποθέτησης κοχλία για τη οστεοσύνθεση καταγμάτων του Α2. Από τις μελέτες που αφορούσαν συγκεκριμένους πληθυσμούς, οι οκτώ αφορούσαν ασιατικούς πληθυσμούς, μόλις δύο μελέτες έγιναν σε μη Ασιάτες. Καταδείχθηκε ότι ήταν κατά κανόνα εφικτή η τοποθέτηση διαπεταλιακής βίδας της συνήθους διαμέτρου 3,5 mm, με εξαίρεση δύο μελέτες. Προτάθηκε κυρίως προεγχειρητική CT (οκτώ μελέτες), αλλά και προεγχειρητική CT με τρισδιάστατη ανασύνθεση (πέντε μελέτες). Σε δύο από τις 16 μελέτες που έγιναν αποκλειστικά με CT, βρέθηκε ότι ένας σημαντικός αριθμός ασθενών δεν μπορούσε να δεχθεί τυπικό κοχλία και συνεστήθη προεγχειρητική CT με τρισδιάστατη ανακατασκευή. Οι γενικά υψηλές τιμές στις πτωματικές μετρήσεις θα μπορούσαν να συσχετιστούν με την υψηλή συμμετοχή ηλικιωμένου πληθυσμού, με αυξημένες πιθανότητες εκφυλιστικής νόσου της σπονδυλικής στήλης, γεγονός που μεταβάλλει τις ανατομικές παραμέτρους, σύμφωνα με τη βιβλιογραφία. Πράγματι, οι πέντε πτωματικές μελέτες έδειξαν ότι η τοποθέτηση της συνήθους διαπεταλιακής βίδας στον Α2 ήταν γενικά εφικτή. Από τις 39 μελέτες που συσχέτισαν την ανατομία του αυχένα του Α2 με την τοποθέτηση κοχλία, στις επτά συνεστήθη προεγχειρητική CT, στις τρεις προεγχειρητική CT προσαρμοσμένη στην πορεία του κοχλία, στις έξι CT με τρισδιάστατη ανασύνθεση, σε μία μελέτη συνεστήθη προεγχειρητική CT αγγειογραφία με τρισδιάστατη ανασύνθεση. Από τις μελέτες που αφορούσαν συγκεκριμένους πληθυσμούς, δέκα εστίασαν σε ασιατικούς πληθυσμούς, μόλις δύο σε μη ασιατικούς πληθυσμούς. Οι πέντε καθαρά πτωματικές μελέτες έδειξαν ότι η ανατομία του αυχένα του Α2 επέτρεπε γενικά την τοποθέτηση τυπικού κοχλία και σε μόλις μία συνεστήθη διεξοδική προεγχειρητική αξιολόγηση. Αντίθετα, οι 22 από τις 24 μελέτες που πραγματοποιήθηκαν αποκλειστικά με CT συνέστησαν πιο έντονα μια διεξοδική προεγχειρητική αξιολόγηση. Στη βιβλιογραφία βρέθηκαν επίσης πέντε μελέτες στις οποίες πραγματοποιήθηκαν μετρήσεις στην οδοντοειδή απόφυση σε συγκεκριμένους πληθυσμούς, εκ των οποίων τρεις ήταν ασιατικοί και δύο μη ασιατικοί. Μόλις σε δύο μελέτες συνεστήθη συγκεκριμένη προεγχειρητική απεικόνιση (CT). Σε ό, τι αφορά το εγκάρσιο τρήμα του Α2, από τις πέντε μελέτες που βρέθηκαν στη βιβλιογραφία, οι τρεις εστίασαν σε ασιατικούς και οι δύο σε μη ασιατικούς πληθυσμούς. Τα αποτελέσματα της παρούσας μελέτης δείχνουν ότι η μέση διάμετρος του αυχένα του Α2 σε αυτή τη σειρά των Ελλήνων ασθενών είναι μικρότερη από αυτή που βρέθηκε από άλλους συγγραφείς σχετικά με ασιατικούς και δυτικούς πληθυσμούς. Αυτά τα ευρήματα δεν συμφωνούν με τα βιβλιογραφικά δεδομένα, σύμφωνα με τα οποία οι αυχένες του Α2 έχουν μικρότερη διάμετρο στους Ασιάτες σε σύγκριση με τους δυτικούς πληθυσμούς. Υπογραμμίζονται οι ανατομικές διαφορές μεταξύ πληθυσμών και η σημασία της διεξοδικής προεγχειρητικής απεικόνισης, δεδομένου ότι σημαντικός αριθμός μελετών που συνιστούν απλή CT είναι πτωματικές, και, επομένως, όπως δείχθηκε, ενδέχεται να περιλαμβάνουν ψευδώς αυξημένες τιμές στις μετρήσεις. Επίσης, διαπιστώθηκε σχετική έλλειψη μελετών σχετικά με μη ασιατικούς πληθυσμούς. Περαιτέρω έρευνα θα μπορούσε να διευκρινίσει εάν η ανατομία του οδόντα, του αυχένα και του πετάλου του Α2 επιτρέπει την τοποθέτηση βιδών σε ένα ευρύτερο φάσμα πληθυσμών και πιθανώς εάν συνιστώνται διαφορετικά προεγχειρητικά πρωτόκολλα απεικόνισης. Επίσης, η παρούσα μελέτη κατέδειξε την υπεροχή της εγκάρσιας διαμέτρου του εγκαρσίου τρήματος του Α2 στον συγκεκριμένο ελληνικό πληθυσμό σε σχέση με άλλους πληθυσμούς. Σύμφωνα με τη βιβλιογραφία, τα εγκάρσια τρήματα μικρής διαμέτρου μπορεί να σημαίνουν μια υποπλαστική σπονδυλική αρτηρία, η οποία μπορεί να οδηγήσει σε ισχαιμικά επεισόδια, ενώ παραλλαγές της πορείας της σπονδυλικής αρτηρίας εντοπίστηκαν συχνότερα στον Α2. Περαιτέρω έρευνα θα μπορούσε να διευκρινίσει εάν γενετικοί παράγοντες επηρεάζουν τις διαστάσεις των εγκαρσίων τρημάτων σε διάφορους πληθυσμούς και αν αυτές οι διαστάσεις συσχετίζονται με κίνδυνο ισχαιμικών επεισοδίων.

Summary Objective We aimed to explore to what extent the literature supports that the use of cadaveric computed tomography can play an important role in anatomy education. Materials and methods PubMed, SCOPUS, Education Resources Information Center and Cochrane Databases were searched for papers with purpose to explore the outcomes of the use of cadaveric computed tomography scans in anatomy education. The following data were obtained from each paper: authors, number of participants, type of study (comparative or not), level of outcome according to Kirkpatrick hierarchy, possible evaluation of statistical significance, acquisition of anatomical knowledge after the educational intervention and perceptions about the effectiveness of this intervention in anatomy learning. Results Seven articles were included. Four of them evaluated students’ knowledge after the use of cadaveric computed tomography scans in anatomy education and three papers evaluated only students’ perceptions. Generally, the outcomes, which mainly concerned students’ perceptions, were positive, while it was showed that students’ academic performance may also be improved. Conclusions The outcomes of the use of cadaveric computed tomography scans in anatomy education encourage the implementation of this teaching modality in anatomy curricula. Further research, including comparative studies with evaluation of acquisition of students’ knowledge, is needed to show if cadaveric computed tomography will be proved a remarkable supportive tool in anatomy educators’ hands.

Background Oxidized zirconium (OxZi) is a relatively new type of material that combines the strength of a metal with the surface/wears properties of a ceramic. Our aim was to investigate whether OxZi femoral heads lead to lower polyethylene wear, higher survival rate, and better clinical outcomes than the other bearing types in patients treated with total hip arthroplasty (THA). Methods Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms: a. “oxidized” AND “zirconium” AND “total” AND “hip” AND “arthroplasty”; b. “oxinium” AND “total” AND “hip” AND “arthroplasty”. The primary outcome measures were the survival rate of the bearing surfaces as well as the polyethylene wear. Results The vast majority (85.7%) of the studies, which reported the mean polyethylene wear rate, showed that there was not any significant difference between OxZi and cobalt-chrome (CoCr) femoral heads (rate ratio: 0.836; 95% confidence interval: 0.362-1.928; P = .674). All studies comparing the survival rate of OxZi and CoCr femoral heads illustrated almost excellent survivorship with both implants. Conclusion OxZi femoral heads did not lead to lower polyethylene wear rate or higher survival rate, when compared with CoCr femoral heads in patients treated with THA. On the basis of these results and taking into account the higher cost of these implants, we would not recommend the routine use of OxZi femoral heads in primary THAs. Level of Evidence Systematic review and meta-analysis of therapeutic studies I-III.

We aimed to evaluate the quantity and quality of current evidence concerning the outcomes of use of plastinated specimens in anatomy education. We performed a narrative literature review, searching for papers dealing with the use of plastination in anatomy education. PubMed, Scopus, ERIC, Cochrane, Web of Science and CINAHL complete electronic databases were searched. The following data were extracted: author(s), year of publication, type of study (comparative or not), number of participants, evaluation of statistical significance, educational outcomes and their level according to Kirkpatrick hierarchy. Six studies were eligible for analysis. Five of them evaluated only students’ reactions about plastination and one study also assessed their examinations results. There were four non-comparative and two comparative studies. Only a study evaluated statistical significance (p

It was our pleasure to read the systematic review and meta-analysis by Moro et al. (2021), who showed that the use of virtual reality (VR) and augmented reality (AR) in anatomy and physiology education did not lead to significant acquisition of knowledge in comparison with traditional two-dimensional (2D) methods. We consider that the findings are interesting and important, because other systematic reviews of anatomy education literature (Yammine and Violato, 2015; Triepels et al., 2020) showed that three-dimensional (3D) digital technologies were proven superior to 2D methods in terms of effectiveness. We would like to propose an alternative interpretation of the findings of the meta-analysis by Moro et al. (2021), taking into account the definitions which were provided for VR and AR and may cause confusion (Kurul et al., 2020; Chytas et al., 2021).

The reconstruction of the hip joint in patients suffering from developmental hip dysplasia (DDH) is a demanding procedure and presents many challenges to the reconstructive surgeon. Higher rates of mechanical complications are present in this group of patients. The results of cemented and uncemented implants used in DDH patients are very promising, according to recent outcomes. However, the surgeon has to be aware of several complications, in order to establish an uneventful surgical management of DDH. The specific article investigates the technical challenges and clinical results of total hip arthroplasty in patients with DDH.

Methods of anatomical education have, as with many facets of normal life, been forced to evolve rapidly due to the Covid-19 pandemic. Whilst some authors claim that cadaver dissection is now under threat, we believe the centuries-old practice can and must be upheld.

This study was performed to determine whether Autologous Matrix-Induced Chondrogenesis (AMIC) is an effective and safe treatment option for patients with symptomatic Osteochondral defects of the Talus (OCTs) and to identify factors that influence the clinical outcome. A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three reviewers independently conducted the literature search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. The databases were queried using the terms “autologous” AND “matrix” AND “induced” AND “chondrogenesis.” Thirteen studies were eligible for review. All studies that compared the preoperative and postoperative mean values of different clinical/functional scores showed significant clinical improvement. The final postoperative mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score ranged from 50.9 to 74.5. The included studies indicated that age and body mass index may have a detrimental impact on the postoperative outcome. A higher re-intervention rate is expected with the open technique, mainly because of hardware removal after malleolar osteotomy. This data analysis demonstrated that both arthroscopic and open AMIC procedures are effective and safe for the treatment of OCTs. Level IV, systematic review of therapeutic studies.

Summary Osteoarthritis affects over 300 million people worldwide. Here, we conduct a genome-wide association study meta-analysis across 826,690 individuals (177,517 with osteoarthritis) and identify 100 independently associated risk variants across 11 osteoarthritis phenotypes, 52 of which have not been associated with the disease before. We report thumb and spine osteoarthritis risk variants and identify differences in genetic effects between weight-bearing and non-weight-bearing joints. We identify sex-specific and early age-at-onset osteoarthritis risk loci. We integrate functional genomics data from primary patient tissues (including articular cartilage, subchondral bone, and osteophytic cartilage) and identify high-confidence effector genes. We provide evidence for genetic correlation with phenotypes related to pain, the main disease symptom, and identify likely causal genes linked to neuronal processes. Our results provide insights into key molecular players in disease processes and highlight attractive drug targets to accelerate translation., Graphical abstract, Highlights • A multicohort study identifies 52 previously unknown osteoarthritis genetic risk variants • Similarities and differences in osteoarthritis genetic risk depend on joint sites • Osteoarthritis genetic components are associated with pain-related phenotypes • High-confidence effector genes highlight potential targets for drug intervention, A multicohort genome-wide association meta-analysis of osteoarthritis highlights the impact of joint site types on the features of genetic risk variants and the link between osteoarthritis genetics and pain-related phenotypes, pointing toward potential targets for therapeutic intervention.